I had upper jaw surgery but should have had double

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damontes2
Posts: 1
Joined: Tue Jun 06, 2017 3:21 am

I had upper jaw surgery but should have had double

#1 Post by damontes2 »

Hello there,

Just to put things into perspective, a year ago I opened up a thread (http://www.archwired.com/phpbb2/viewtopic.php?t=50407) with my original username, in case anyone wants to read it. I've lost my password for that account ever since and for some unknown reason I am unable to recover it (I guess it might have to do with my having too few posts), so I've just created another one.

Anyway, long story short: a year ago I had a Le Fort 1 procedure done to fix my underbite. I wasn't really sure that was the exact procedure I needed, but my surgeon and orthodontist somehow convinced me that my imbalance problem didn't come as much from having a large mandible as it came from having a receded maxilla. I trusted them and went ahead with everything, but deep inside I continued to feel somewhat insecure about how much the aesthetic result would please me. Prior to wearing braces, I actually expressed my concern openly quite a few times and told them how I felt that the right surgery for me would be bimax. But the thing is, I just felt it. Instead, they knew. I was just projecting my fears while they were stating an objective opinion, untarnished by my insecurities and backed up by their knowledge. I had to believe them. But, seriously, it was rather obvious. I have a very long, flat face. How do you fix that without cutting here and there?

And here I am now. A year post-op my surgeon goes ahead and tells me that the ideal solution for my case was double jaw surgery, but that they thought a pretty good result could also be achieved just by moving my maxilla forward. "It was a double jaw surgery case, but we camouflaged it with a Le Fort". Like that, literally. Errr... I don't know, man, I'm confused. I can't say for a fact that I would be enthused with my face had I had bimax surgery, but I feel like the whole truth was not said to me back then, which might have made me take another route. I suppose at this point he no longer remembers how I saw the whole thing three years ago, or else he wouldn't be saying those things to me. To top things off, he's also informed me that I'll have to wear my retainers for my whole life, unless I'm willing to see my teeth going back to their original position (he's complemented this lovely piece of news by saying that that wouldn't be necessary at all with bimax).

So my question is, how can something like this happen? This surgery is hard enough for us to go through on multiple levels that we don't want to end up with a result far from ideal. What's worse, I feel like my options to have a normal face have been completely removed now, since having a second surgery would probably be a crazy af thing to do.

Or wouldn't it?

snapdresser
Posts: 996
Joined: Wed Feb 18, 2015 7:31 am

Re: I had upper jaw surgery but should have had double

#2 Post by snapdresser »

Oof. A decision like that warrants more info on your part, I think. What would be the difference besides not having to wear retainers forever? What sort of movements would they do if you had a bimax done now? The good thing is that it sounds like they'd be pushing your mandible back which can be done with IVRO so you'd have a low chance of permanent numbness. That in and of itself makes it a little less crazy IMO. That said, I suspect it's a pretty good "camouflage" job so if there wouldn't be much benefit besides the retainers, I'd just stick with the retainers. If the retainers are enough of a nuisance, they can always put in permanent ones. I have a wire behind my lower teeth that acts as a permanent retainer so I no longer have to wear mine after having braces many years ago.
No braces
1-piece LeFort I + BSSO + Sliding Genio on 10 JUNE 2015!
Partial hardware removal 14 SEP 2018
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djsmama
Posts: 4
Joined: Sat Jul 01, 2017 1:41 pm

Re: I had upper jaw surgery but should have had double

#3 Post by djsmama »

Hi, damontes. I'm the mother of a soon-to-be-double-jaw-surgery patient and your post caught my eye because we've recently been thrown into confusion about a similar matter. My son (he's almost 21) moved to the U.S. from Canada, where he lived for a few years with his father, a couple of years ago. So he began the orthodontic portion of his treatment (expander) in Canada then got his braces on and began working with an oral surgeon here. So we've seen a few different people. We have been told, at various times, that he would need maxillary surgery only, mandibular surgery only, and double jaw surgery. Granted, only two (!) of those opinions came from the oral surgeon herself; she initially said he'd need both, but most recently said only bottom, though when I questioned her about the inconsistency she apologized and explained that she hadn't yet completed her cephalometric analysis and wouldn't know for certain until she did. She's world renowned in the field, so I feel we have no choice but to trust her on that, but it was disconcerting.

I don't have any advice for you, just sympathy. It's a lot to have gone through to end up second-guessing yourself and not feeling confident with the result. FWIW, it's been my observation that going through this kind of treatment tends to make people hyper-aware of aspects of their appearance that they otherwise may not have ever noticed or been dissatisfied with, and I've never seen after photos of anyone who I didn't think looked great post surgery.

I wish you peace.

djsmama
Posts: 4
Joined: Sat Jul 01, 2017 1:41 pm

Re: I had upper jaw surgery but should have had double

#4 Post by djsmama »

I guess what I was trying to say is, I'll bet you look a lot better than you realize. It was crappy of your surgeon to speak of about it so cavalierly; he should know that the people he's working with have been made hyperaware of their appearances. I never, ever noticed things like underbites or minor jaw assymmetries or open bites before we began this journey. Now that I really think about it, I STILL don't notice them in other people. I just notice them in my son, because so much of our existence is focused on them right now. I found the consultation process absolutely brutal even when people were clearly trying to choose their words carefully.

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